Serum Placental Growth Factor and Uterine Artery Pulsatility Index as Predictor of Preeclampsia.
Keywords:
Placental growth factor (PIGF), uterine artery pulsatility index (UtA-PI), PreeclampsiaAbstract
Background: Early identification of pregnant women at high risk for developing preeclampsia by measuring placental growth factor (PlGF) and uterine artery pulsatility index (UtA PI) levels could allow for earlier definite management and could potentially reduce the risk of complications of preeclampsia.
Objective: This study aimed to assess the efficacy of serum placental growth factor (PlGF) and uterine artery pulsatility index (UtA PI) as predictors for preeclampsia.
Methods: This prospective cohort study was conducted in the Department of Fetomaternal Medicine of Bangladesh Medical University (BMU) from November 2021 to October 2022. A total of 63 singleton pregnant women were enrolled purposively at 20-24 weeks of gestation. At enrolment UtA PI and serum PlGF were measured in each study subject. All the subject were then followed up till delivery for development of preeclampsia. The PI (pulsality index) was measured using uterine artery Doppler and the placental growth factor (PlGF) level was estimated from blood samples using ELISA. Uterine artery pulsatility index more than 95th percentile and serum placental growth factor less than 100 pg/mL were considered the baseline cut-off values using the Youden Index. In this study pregnant women having UtA PI above 95 percentile and PlGF below 100 pg/ml at thenrolment were predicted to develop preeclampsia. The diagnostic efficacy of UtA PI and PlGF alone and in combination were determined for prediction of preeclampsia.
Results: Among the study subject 46% were estimated to have low serum PlGF levels and 26.9% had an increase in UtA-PI at 20-24 weeks of pregnancy. Subsequent follow-ups revealed the development of pre- eclampsia (PE) in 12(19%) patients. Patients with preeclampsia had significantly lower serum PlGF levels (80.8±58.8 pg/mL) compared to those without PE (206.2±162 pg/mL, p=0.011). UtA-PI was higher in patients with preeclampsia compared to those without PE (1.5±0.4 vs. 0.9±0.18, p<0.001). Low PlGF levels increased the risk of preeclampsia 12.9 times (p<0.001), while elevated UtA-PI raised the risk 29.8 times (p<0.001). Above four fifths (83.3%) of PE group of patients had combination of low PIGF and elevated UTA-PI while it was absent in majority (90.2%) of the women with no preeclampsia. The elevated UtA-PI with combination of low PlGF strengthens the predictive values for preeclampsia with reported sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of 83.3%, 90.2%, 66.7%, 95.8%, and 88.9% respectively.
Conclusion: The combination of PlGF and UtA-PI is a good tool for predicting the development of preeclampsia.
Bangladesh Medical Res Counc Bull 2026;52(2): 109-114
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Copyright (c) 2026 Jannatul Ferdaus, Mishkat Tabassum , Nowroj Ahmed , Mst. Sharmin Ferdous , Nahreen Akhter , Rahima Perveen
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